


Breathtaken

by joyeusenoelle



Category: Elementary (TV)
Genre: Gen
Language: English
Status: Completed
Published: 2014-12-20
Updated: 2014-12-20
Packaged: 2018-03-02 08:03:34
Rating: General Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 1,362
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/2805446
Author URL: https://archiveofourown.org/users/joyeusenoelle/pseuds/joyeusenoelle
Summary: <blockquote class="userstuff">
              <p>Joan Watson has been working 28 hours in the ER without a break. Of course, that's when the ambulance pulls up.</p>
            </blockquote>





	Breathtaken

**Author's Note:**

  * For [ancarett](https://archiveofourown.org/users/ancarett/gifts).



Joan Watson had been awake for 28 hours when the dying girl showed up in the emergency room. The ambulance pulled in as Joan was discharging another patient - asthma attack, just needed a nebulizer and time to calm down - and she was pulled into the fray as the girl was wheeled into the ER. African-American, a teenager, barely breathing, bradycardia. She took the handwritten “chart” from the EMT. “She called in for a heart attack?”

“That’s what she said on the 911 call,” the EMT - Jameson, she saw - said. “She was hyperventilating, her heart was pounding, she said she thought she was having a heart attack. By the time we got there she was unconscious on the floor.”

“A heart attack in a teenager doesn’t make sense. Any idea if she has a history?”

They arrived at the first empty treatment room in the ER. The EMT shrugged. “She was alone when we found her. Nobody else in the house. It was pretty bare.” He glanced over his shoulder. “Look, I gotta get back, it’s all on the slip.”

“Yeah, okay, go.” Joan turned back to the girl. The EMTs had intubated sloppily with a breath bag, which a nurse was squeezing rhythmically; Joan adjusted the seal, then looked at the heart monitor. Still brady, and slowing with each beat. “Atropine, two milligrams,” she called to another nurse, who hurried to prepare a needle. Joan took it and slipped the needle into a vein in the girl’s arm, but it did nothing to stop the slowing of the heartbeat.

Joan, the nurses, and another doctor - Peters, usually up in diagnostics; they rarely pulled the same ER shift - continued for another ninety seconds to resuscitate the girl, but the heartbeat finally slowed to nothing, and resisted all attempts to bring it back. At 2:41 AM, Joan Watson declared the girl dead, and slumped back against the wall, letting the nurses begin to remove the monitors, IVs, and intubation.

Peters touched Joan’s shoulder, and she flinched. “Hey,” he said. “How long have you been up?”

“Just 28 hours. I’ve got eight until my shift’s over.”

“Go take twenty in the rest room. I can handle anything that comes in for the next few minutes.”

“You’re sure?” Joan asked. Peters nodded and patted her shoulder. “Thanks. I owe you.”

“Just pick up my slack next time, and we’ll be even.”

Joan was at the door when she looked over her shoulder. “Hey, you ever hear of a teenager going into arrest like this?”

Peters shrugged. “Might just be a heart condition. Autopsy’s not our job, though.”

“Yeah, okay. Thanks again.”

Joan made her way to the rest room - basically a couple of cots in a storage closet - and lay back on one of the mattresses. She set an alarm on her watch: fifteen minutes, so she’d have another five to find a cup of coffee. She would never admit it, but the long shifts were getting to her, and she was desperately looking forward to being in her own bed, with her own mattress and her own sheets and her own ancient T-shirt that served as pajamas. 

She closed her eyes, but sleep didn’t come, so she listened to the hum of the fluorescent lights and the distant din of the emergency room’s early-morning activity. It felt like ten minutes that she lay there, waiting and listening, when she heard footsteps in the hall outside - barefoot, coming closer to the door. She sat up, expecting to see a confused patient. Instead she saw the girl, upright and smiling, her skin dark even under the lights, her hair puffed out around her head. She glanced at Joan, took a long drag of a cigarette, and then she was out of sight, past the other side of the doorway.

Joan dashed to the door, but the girl was gone entirely - no shape going around a corner, no sound of footfalls, not even the scent of cigarette smoke.

She returned to the emergency room, and pulled aside the first nurse she saw. “The girl who came in earlier in the ambulance - not breathing, bradycardia - is she still here?”

The nurse raised an eyebrow. “They’re taking her down to the morgue now. You might still catch ‘em if you run.”

Joan did. The attendants were just wheeling the girl into the elevator when she arrived, and she slipped into the elevator with them. “Everything all right, doctor?” one of them asked.

“Fine, just fine.” Joan bent over the girl’s body, pulling back her lips. Her teeth were white and straight, obviously well-cared-for, with no signs of tar stains. Her fingertips were pale with death, but likewise didn’t show any yellowing. 

Joan straightened back up. “She hasn’t, you know… gotten back up, has she?”

The attendants looked at each other. “You’re the one who declared her dead, doctor,” the same one said.

“Of course. I just thought I saw…” Joan shook her head. “Never mind.”

She set the girl’s hand back down, but picked it up again almost immediately. “Chafing around the wrists. Like she’d been tied up. Or handcuffed.”

The other attended half-smiled. “Not one of us, doc.”

“I know, I know. Pre-mortem.” The elevator bell rang, and the doors opened on the chill of the morgue. She stepped out to let the attendants pass, then paused. “Actually… I’ll take this one in.” She held her hand out for the attendant’s clipboard, holding the girl’s handwritten EMT sheet and the official hospital documentation.

“We’re really supposed to deliver her—” one of the attendants started, but Joan shook her head.

“To one of the doctors in the morgue, right? I’m a doctor, and I’m in the morgue. You’re fine. I’ll sign off.”

“If you say so.” The attendant with the clipboard shrugged and handed it over, and Joan signed her name at the bottom. “Okay,” the attendants said in unison, and stepped back into the elevator.

Joan smiled at them until the door closed, then looked down at the sheet. Respiratory difficulty and bradycardia, she knew that. Blood pressure very low - she was surprised the girl had been conscious enough to call 911. She opened the girl’s mouth again, and saw marks on the tongue; she’d bitten it at some point recently, although not hard enough to sever anything. A seizure, or tremors. 

There was something here. She just had to put it together. 

Respiratory failure, bradycardia, hypotension, seizure. It added up to… a congenital heart condition? The vision of the girl in the hallway nagged at her. She hadn’t smoked, so why had she been carrying the cigarette?

Nicotine. Joan picked the girl’s hand up again, staring at the skin between the fingers. “No, no, no, no,” she counted off, then moved to the other side. “No, no… yes.” There, between the middle and ring fingers, was a pinprick, a spot still reddened against the girl’s pallor. An injection site. The girl’s condition fit the symptoms of nicotine poisoning - easy to mistake as a natural death from heart failure. But this girl had been poisoned - probably by the same people who’d cuffed her.

Joan looked around, felt her pockets, and pulled out a swizzle stick from the coffee she’d had … twelve hours ago? It would have to do. She slipped the stick under the girl’s palm and bent it up between her ring and middle fingers, marking the position of the injection site.

She wheeled the gurney into the morgue proper and the mortician, Nalini Singh, looked up. “Hand-delivering today, Dr. Watson?” she asked with a smile.

Joan returned the smile. “There’s more here than we thought. Would you run a test on cotinine in the blood, please? I have a call to make.”

“Sure thing,” Singh replied. “Just as soon as I’m done with this one.”

“Thanks,” Joan said, and slipped out to the telephone in the hallway. She listened for the dial tone, then dialed the local police precinct.

The cop on the other end sounded bored. “Eleventh Precinct, Sergeant Bell speaking,” he said. “How may I direct your call?”

“Sergeant, you’re going to want to send someone down here. I think I’ve found a murder.”


End file.
